20143330Healthcare Services Quality in Malaysian Private Hospitals: A Qualitative Study22Background and objectives: Services quality has become the major concern of policy-makers in the present rapidly growing consumer-oriented health industry. However, there is a major gap in the relevant literature in Malaysia in this particular field. Thus, this research attempted to narrow this gap by conducting a qualitative study to gain insight into quality of healthcare services in the Malaysian private hospitals, as perceived by the patients. Methods: This interview-based study was conducted between November 2013 and January 2014. A sample of fourteen patients was randomly selected for interview, from three major Malaysian private hospitals, including Kuala Lumpur Pantai Hospital, Prince Court Medical Centre, and KPJ Ampang Puteri Specialist Hospital. Interview data were collected using a semi-structured questionnaire designed based on literature review. The major themes of healthcare services quality was extracted by iterative review of the interview transcripts. Findings: Analysis of interview data identified three important aspects of healthcare services quality as perceived by the interviewed patients, including cost and location of services delivery, the quality of patient care, availability of adequate facilities. Conclusions: By identifying major factors of patient satisfaction in the private healthcare sector, this study can guide development of effective strategies leading to a higher quality of health services in Malaysia. The study also sets a baseline for future large-scale studies aimed at improving understanding of patients’ unmet expectations from the health system.1-103112--AbdullahSarwarDepartment of Business Administration, Faculty of Economics and Management Sciences, International Islamic University MalaysiaDepartment of Business Administration, FacultyMalaysiasunabdullah@gmail.comQuality of health servicesPatient Satisfactionprivate hospitalHospital managementand Health services deliveryCostLoyaltycustomer satisfactionPrescribing Pattern of Psychotropic Medications in Psychiatry Outpatients at a Tertiary Care Teaching Hospital in India: A Prospective Cross-sectional Study22Background and Objectives: The expanding field of psychopharmacology is constantly seeking new and improved drugs to treat psychiatric disorders. Although psychotropic drugs have had a remarkable impact in psychiatry, their utilization, effectiveness, and side effects in the in clinical practice need continuous study. The present study was thus designed to analyze the pattern of psychotropic drugs prescription in a tertiary care teaching hospital in Eastern India. Methods: A 6-month prospective cross-sectional observational clinical study was carried. The study enrolled a total of 294 cases to investigate the prescribing pattern of psychotropic medications, using a predesigned format. Findings: Major depression was found to be the most common psychiatric disorder encountered (34.69%). The number of psychotropic drugs prescribed per patient averaged 3.39. Anti-anxiety drugs were the most frequently prescribed psychotropic drugs in various psychiatric disorders. Psychotropic fixed dose combinations were present in 18.36% of the prescriptions. A majority (83.09%) of medicines was prescribed by generic names. Psychotropic drugs accounted for 69.2% of drugs prescribed from the hospital drug schedule, of which 60.2% actually dispensed from the hospital drug store free of cost. Utilization of drugs from the national list of essential medicines of India (NLEM 2011) was 45.63%. Conclusions: This study provides a baseline data for carrying out further studies on prescribing pattern in a tertiary care unit which would help for improve psychotropic drugs utilization in mental health facilities.1-113122--ShatavisaMukherjeeDepartment of Clinical and Experimental Pharmacology, School of Tropical Medicine, Kolkata, IndiaDepartment of Clinical and Experimental PharmacoloIndiashatavisa100@gmail.com--SukantaSenDepartment of Clinical and Experimental Pharmacology, School of Tropical Medicine, Kolkata, IndiaDepartment of Clinical and Experimental PharmacoloIndiadrsukant@gmail.com--SeshadriChatterjeeDepartment of Psychiatry, Medical College and Hospital, Kolkata, IndiaDepartment of Psychiatry, Medical CollegeIndiaitismeseshadri@gmail.com--ArunavaBiswasDepartment of Clinical and Experimental Pharmacology, School of Tropical Medicine, Kolkata, IndiaDepartment of Clinical and Experimental PharmacoloIndiadr.sukantsen@yahoo.co.in--SatwikaSinhaDepartment of Biochemistry, Calcutta National Medical College, Kolkata, IndiaDepartment of Biochemistry, Calcutta NationalIndiadrsatwika@yahoo.co.in--MalayGhosalDepartment of Psychiatry, Medical College and Hospital, Kolkata, IndiaDepartment of Psychiatry, Medical CollegeIndiamalay_ghosal@yahoo.in--SantanuTripathiDepartment of Clinical and Experimental Pharmacology, School of Tropical Medicine, Kolkata, IndiaDepartment of Clinical and Experimental PharmacoloIndiasantanutripathi93@gmail.comPrescriptionDrug utilizationPsychotropic medicationsTertiary care hospitalResponsiveness in the Healthcare Settings: A Survey of Inpatients22Background and Objectives: Responsiveness is one of the hallmarks of high performance health systems. Maintaining the responsiveness of health organizations at high level, require constant assessment of its situation as perceived by the patients. The accumulation of data on patients’ perception of health organizations’ responsiveness can help policy-makers in developing effective relevant strategies. Thus, the aim of this study was to survey the perceived responsiveness of the teaching hospitals of Zanjan City, Iran. Methods: This cross-sectional study was carried out at the Zanjan University of Medical Sciences between 2013-2014. A total of 246 inpatients were selected systematically at the time of their discharge. The responsiveness questionnaire recommended by the World Health Organization’s (WHO) was used for the study instrument, which evaluate the responsiveness in terms of dignity, communication, autonomy, confidentiality, prompt attention, quality of basic amenities, choice of provider, and social support. Data were summarized using descriptive statistical methods. T-test and ANOVA was used for comparing the mean values. Findings: More than half of the inpatients rated overall responsiveness as good (58.4%). The confidentiality dimension gained the higher score (82.5%), followed by communication (72.3%), and prompt attention (70.3%). The choice dimension was evaluated as the weakest aspect (22.8%) of the responsiveness. While dignity was perceived to be the most important aspect of responsiveness, confidentiality gained the lowest perceived importance (62%). Old patients expressed a higher evaluation of overall responsiveness and some of its dimensions, including dignity, autonomy, and choice compared with the young patients. In addition, illiterate patients expressed a significantly higher assessment of responsiveness and some of its dimensions, including dignity, autonomy, and communication. Conclusions: Our results ranks the status of different dimensions of responsiveness as perceived by the patients and reveals those areas needing further attention to improve such as social support, autonomy, and choice of provider. The fact the younger and more educated patients expressed lower assessment of responsiveness’s dimensions in, highlights the importance of attention to the specific expectations of these groups and to maintain a high level of responsiveness in the health settings.1-123132--AliMohammadiDepartment of Public health, School of Public Health, Zanjan University of Medical Sciences, Zanjan, IranDepartment of Public health, School of PublicIran--KooroshKamaliDepartment of Public health, School of Public Health, Zanjan University of Medical Sciences, Zanjan, IranDepartment of Public health, School of PublicIrandrkamali@zums.ac.irRresponsivenessInpatientsHospital managementHospital PerformancePatient Satisfactionhealth systemCareer Anchors Assessment: A Survey of Personnel of Vice-chancellor Offices in Shiraz University of Medical Sciences22Background and Objectives: A career anchors consists of jobs that a person holds in order to achieve a professional goal. Career anchors development management results in job satisfaction, professional commitment, and higher effectiveness. The purpose of this study was to determine different dimensions of career anchors among in the personnel of vice-chancellor offices of Shiraz University of Medical Sciences. Methods: This cross-sectional study was conducted in 2012. The study sample was 236 personnel of the Vice-chancellor offices of Shiraz university of Medical Sciences, selected using ratio estimation method. The 43-item Schein's career anchors orientation inventory was used as the study instrument. T-test, ANOVA and Spearman coefficient were used for data analysis. Findings: The highest mean score of career anchors was observed in service port (3.28 ± 0.43) and the lowest mean was observed in identity port (2.47 ± 0.5). Significant inverse relationships were found between age and work experience in the innovation port. There was also significant difference between genders in service and security ports. Conclusions: The main career anchor was related to services port, which highlights the importance providing quality health care services to the patients. In order to improve work situation it is recommended to hire well-educated managers for job development and provide educational courses for managers and personnel.1-133138--NahidHatamSchool of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, IranSchool of Health Management and InformationIranhatamn@sums.ac.ir--AsiyehSalehiPopulations and Social Health Research Program, Griffith Health Institute, Griffith University, QLD, AustraliaPopulations and Social Health Research Program,Australianasim.salehi@griffithuni.edu.au--VidaKeshtkaranSchool of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, IranSchool of Health Management and InformationIranv.keshtkaran@gmail.com--ParvanehHeidari-OrojlooHealth Management and Economics Research Center, School of health
Management and Information Sciences, Iran University of Medical Sciences, Tehran, IranHealth Management and Economics ResearchIranparvane.heidari@gmail.com--MaritaMohammadshahiDepartment of Health Economics and Management,
School of Public Health, Tehran University of Medical Sciences,
Tehran, IranDepartment of Health Economics and Management,
SchIranram.malihe@yahoo.comCareer anchorsjob motivationJob SatisfactionThe Relationship between Job Satisfaction, Job Motivation, and Organizational Commitment in the Healthcare Workers: a Structural Equation Modeling Study22Background and Objectives: Healthcare human resources management is a challenging and multi-faceted task. Study of the interrelation of various variables affecting the performance of the healthcare workers resources can provide insight into effective management of human resources in the health settings. Hence, this study aimed to explore the relationship between job satisfaction, job motivation and organizational commitment in the healthcare workers. Methods: A sample of 250 healthcare workers was selected from the public hospitals of Boyerahmad Kohkiluyeh Province using cluster sampling method. Job satisfaction was measured by Spector’s job survey, job motivation by Loudahel Kitchener’s survey and organizational commitment by Allen and Meyer’s survey. The relationship between the variables was explored by sstructural equations modeling. Results: Job satisfaction was found to be a significant predictor of job motivation and organizational commitment. In addition, job motivation significantly predicted the organizational commitment. Conclusions: In order to increase organizational commitment of the healthcare workers, the administrators of the healthcare settings should motivate their employees by strategies leading targeting enhancing their satisfaction with job and quality of work life.1-139144--LidaGholizadeIslamic Azad University, Gachsaran Branch, Gachsaran, IranIslamic Azad University, Gachsaran Branch,Iran--IrvanMasoudiIslamic Azad University, Sciences and Research Branch, Tehran IranIslamic Azad University, Sciences and ResearchIran--Mohammad RezaMalekiSchool of Management and Medical Information Services, Tehran University of Medical Sciences, Tehran, IranSchool of Management and Medical InformationIran--AfsoonAeenparastHealth Sciences Institute of Jihad University, Tehran, IranHealth Sciences Institute of Jihad University,Iran--MehdiBarzegarSchool of Health Care Services Management, Tehran University of Medical Sciences, Tehran, IranSchool of Health Care Services Management,IranJob Satisfactionjob motivationorganizational commitmentHealthcare WorkersHealthcare human resourcesHospital managementImpact of Outsourcing Healthcare Services Management on the Quality of these Services22Background and Objectives: Outsourcing healthcare and the associated services has proven as an effective strategy for enhancing hospital performance and improving quality of services. Despite, the concept is relatively new in Iran, calling for studies investigating different aspects of the issue and its potential benefits. Thus, this study was conducted to explore the impact of outsourcing management of healthcare services on quality of these services in a number of teaching hospitals in Iran. Methods: A sample of 113 managers from six teaching hospitals of Tehran University of Medical Sciences (TUMS) was surveyed. A 14-item researcher-made questionnaire was used to record the perception of hospital managers towards the quality of healthcare services before and after signing management contract. Paired t-test was used to compare the mean values. Findings: The quality of healthcare services after outsourcing was found to be significantly higher (P < 0.05) as perceived by the hospital managers, compared with the period before outsourcing. Conclusions: Our results provide further support for the notion that outsourcing management of healthcare services can lead to an improved quality of these services, thereby higher patient satisfaction and enhanced hospital performance.1-145148--MohammadaliZhiarfarDepartment of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, IranDepartment of Health Services Management,Iran--Seyed HesamSeyedinDepartment of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, IranDepartment of Health Services Management,Iran--SogandTouraniDepartment of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, IranDepartment of Health Services Management,Iransogandtourani@yahoo.com--RahimKhodayari ZarnaqHealth Management and Economics Research Center, Iran University of Medical Sciences, Tehran, IranHealth Management and Economics ResearchIran--AliAyoubianHospital Management Research Center, Iran University of Medical Sciences, Tehran, IranHospital Management Research Center, IranIranHealthcare servicesHospital managementOutsourcingHealth services qualityDeveloping a Standardized Medical Speech Recognition Database for Reconstructive Hand Surgery22Fast and holistic access to the patients’ clinical record is a major requirement of modern medical decision support systems (DSS). While electronic health records (EHRs) have replaced the traditional paper-based records in most healthcare organization, the data entry into these systems remains largely manual. Speech recognition technology promises substitution of the more convenient speech-based data entry with currently laborious manual method, in the near future. Developing effective speech recognition systems (SRS) require availability of standardized vocabulary databases. This study was aimed at developing a medical speech recognition database for reconstructive hand surgery based on the Systematized Nomenclature of Medicine-Clinical Terms (SNOMED-CT). All codes related to hand problems were extracted from ICD-10. A sample of 2051 diagnosis codes was randomly selected from the patients’ records. The operation report paper sheets were transformed to electronic records. For each term, the SNOMED-CT was browsed to find the preferred synonym, using CliniClue® Xplore Software. For some words with several number of synonyms, the preference of reconstructive surgery specialists were asked using a researcher-made questionnaire. Ultimately, the preferred words was substituted throughout each document and used for developing a database of standard nomenclature. The developed database was used in speech-based recording clinical data in reconstructive hand surgery operating room and accuracy of 81% in correct recording of clinical data was observed. Therefore, development of standard medical nomenclature databases can facilitate accurate electronic recording of medical data and reduce the associated labor and cost posed by current manual method.1-149154--FatemeSadeghiDepartment of Health Information Technology, School of Allied Health Sciences, Tehran University of Medical Sciences, Tehran, IranDepartment of Health Information Technology,Iranfateme_s2860@yahoo.com--MarjanGhazisaeediDepartment of Health Information Management, School of Allied medicine, Tehran University of Medical Sciences, Tehran, IranDepartment of Health Information Management,Iran--RezaSafdariDepartment of Health Information Management, School of Allied medicine, Tehran University of Medical Sciences, Tehran, IranDepartment of Health Information Management,Iranrsafdari@tums.ac.ir--AbdoljalilKalantarhormoziSchool of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IranSchool of Medicine, Shahid Beheshti UniversityIranClinical RecordsHealth Electronic SystemsElectronic Health RecordsSpeech recognitionDatabaseSoftwareMedical InformaticsHand SurgeryUnder the Table in Health Care System: A Case Report in Iran22Under the table or informal payments in several middle and low income countries is a serious impediment to health care reform. These payments are effectively a form of systemic corruption. This report shows the efforts of a patient who seek health care for his ankle while being requested to pay under the table in hospital and private clinic. The data were collected by interview and surveying patient documents. Informal payments have adverse impact on access and utilization of health services, efficiency, quality and equity. Informal payments lead to false information about the real costs of disease and the patient share of these costs and consequently wrong government policies. Appropriate deterrent sanctions should be imposed on providers that request for under the table payments, especially in the public sector where the government tries to subsidize healthcare to ensure it is accessible to all, especially the poor.1-155158--EdrisHasanpoorHospital Management Research Center, Iran University of Medical Sciences, Hashemi Nejad Hospital, Tehran, IranHospital Management Research Center, IranIranedihasanpoor@yahoo.com--AliJanatiDepartment of Healthcare Management, School of Health Management and Information Sciences, Tabriz University of Medical Sciences, Tabriz, IranDepartment of Healthcare Management, SchoolIranjanati@gmail.com--AbdullaSalehiIranian Center of Excellence in Health management, Tabriz University of Medical Sciences, Tabriz, IranIranian Center of Excellence in Health management,Iran--MobinSokhanvarDepartment of Healthcare Management, School of Public Health, Tehran University of Medical Sciences, Tehran, IranDepartment of Healthcare Management, SchoolIranmobinsokhanvar16@yahoo.com--JavadEbrahimzadehDepartment of Health Economics, School of Health Management and Information Sciences, Tehran University of Medical Sciences, Tehran, IranDepartment of Health Economics, School ofIranebrahimzade.j@gmail.comUnder the table paymentsHealth Care SystemHealth settingPatient